Surgical fasteners and associated deployment devices

ABSTRACT

A surgical fastener and a related deployment device as well as their methods of use are disclosed. In one embodiment, the deployment device includes one or more surgical fasteners including a head and a distally extending coil body attached to the head. The head includes a through hole with an internal thread. The deployment device also includes a mandrel including a threaded portion located at a distal end of the mandrel. The threaded portion is engaged with the internal thread of the one or more surgical fasteners. A rotator is associated with the one or more surgical fasteners such that the rotator can selectively rotate the one or more surgical fasteners relative to the mandrel to displace the one or more surgical fasteners in a distal direction.

FIELD

Disclosed embodiments are related to surgical fasteners and associateddeployment devices.

BACKGROUND

Surgical fasteners are widely used in many different medical procedures.For example, staples, sutures, clips and other fasteners are commonlyused in laparoscopic and open surgical procedures.

SUMMARY

In one embodiment, a deployment device includes a handle and a shaftextending distally from the handle. One or more surgical fastenersincluding a head and a distally extending coil body attached to the headmay be disposed in the shaft. The head includes a through hole with aninternal thread. The deployment device also includes a mandrel includinga threaded portion. The threaded portion is engaged with the internalthread of the head of the one or more surgical fasteners. A rotator isassociated with the one or more surgical fasteners, wherein the rotatorselectively rotates the one or more surgical fasteners relative to themandrel to displace the one or more surgical fasteners in a distaldirection.

In another embodiment, a surgical fastener includes a head including athrough hole with an internal thread and a distally extending coil bodyattached to the head.

In yet another embodiment, a method includes: rotating one or moresurgical fasteners relative to a mandrel in a surgical fastenerdeployment system, wherein the one or more fasteners include a head anda distally extending coil body attached to the head, wherein the headincludes a through hole with an internal thread, and wherein the mandrelincludes a threaded portion constructed and arranged to engage with theinternal thread of the head of the one or more surgical fasteners, andwherein rotating the one or more surgical fasteners relative to themandrel displaces the one or more surgical fasteners in a distaldirection down the surgical fastener deployment instrument.

It should be appreciated that the foregoing concepts, and additionalconcepts discussed below, may be arranged in any suitable combination,as the present disclosure is not limited in this respect. Further, otheradvantages and novel features of the present disclosure will becomeapparent from the following detailed description of various non-limitingembodiments when considered in conjunction with the accompanyingfigures.

BRIEF DESCRIPTION OF DRAWINGS

The accompanying drawings are not intended to be drawn to scale. In thedrawings, each identical or nearly identical component that isillustrated in various figures may be represented by a like numeral. Forpurposes of clarity, not every component may be labeled in everydrawing. In the drawings:

FIG. 1 is a schematic representation of a deployment device;

FIG. 2 is a schematic perspective exploded view of the deployment devicedepicted in FIG. 2;

FIG. 3 is a schematic perspective exploded view of the outer drivecannula and the mandrel holding a plurality of fasteners;

FIG. 4A is a schematic top view of a coil fastener including a head;

FIG. 4B is a schematic front view of the coil fastener including a headof FIG. 4A;

FIG. 4C is a schematic perspective view of the coil fastener including ahead of FIG. 4B;

FIG. 5 is a schematic front view of the threaded portion of a stationaryinner mandrel;

FIG. 6A is a schematic front view of an outer drive cannula;

FIG. 6B is a schematic cross-sectional view of the outer drive cannulaof FIG. 6A taken along line 6B-6B;

FIG. 6C is a schematic perspective view of the outer drive cannula ofFIG. 6A;

FIG. 7A is a schematic cross-sectional view of an outer drive cannulawith a stationary inner mandrel and a plurality of fasteners positionedtherein;

FIG. 7B is a schematic cross-sectional view of the outer drive cannula,the stationary inner mandrel, and the plurality of fasteners of FIG. 7A;

FIG. 7C is a perspective view of the cross section of the outer drivecannula as well as the stationary inner mandrel and the plurality offasteners depicted in FIG. 7A;

FIG. 8A is a schematic top view of a coil fastener including a head;

FIG. 8B is a schematic front view of the coil fastener including a headof FIG. 8A;

FIG. 8C is a schematic cross-sectional view of the coil fastenerincluding a head of FIG. 8A;

FIG. 8D is a schematic perspective view of the coil fastener including ahead of FIG. 8A;

FIG. 9 is a schematic front view of the threaded portion of a stationaryinner mandrel;

FIG. 10A is a front view of a stationary inner mandrel and a pluralityof fasteners positioned thereon;

FIG. 10B is a schematic cross-sectional view of the stationary innermandrel and the plurality of fasteners of FIG. 10A; and

FIG. 10C is a schematic perspective view of the stationary inner mandreland the plurality of fasteners of FIG. 10A.

DETAILED DESCRIPTION

Coil fasteners typically do not include a fastener head which may resultin the uncovered top coil winding contacting adjacent tissue. Further,in instances where a conventional coil fastener is overdriven, the coilfastener may go through an intended prosthetic material and/or tissue itis meant to engage since there is no structure present to prevent thetop coil from passing through the prosthetic material and/or tissue.Consequently, the inventors have recognized the benefits of a fastenerincluding a distally extending coil body including one or more coilwindings that is attached to an associated fastener head. Such afastener offers the benefit of reduced insertion resistance associatedwith a coil fastener while including a head to avoid the coil body fromcontacting adjacent tissue and prevent the coil body from passingthrough the intended prosthetic material and/or tissue. Additionally,the fastener head provides a surface which will abut against a targettissue or prosthetic which may help to prevent overdriving of thesurgical fastener through the intended underlying materials.

In one embodiment, the surgical fasteners include a distally extendingcoil body including one or more coil windings attached to a head with athrough hole including an internal thread or threads. The coil body mayhave a cylindrical shape with a circular cross section, though othershapes are possible including a triangular, rectangular, or any otherappropriately shaped cross section. One or more of the surgicalfasteners may be loaded in a corresponding deployment device. Thedeployment device may include a stationary or movable mandrel forholding the one or more fasteners. The mandrel may also include anexternally threaded portion located at a distal end of the mandrel. Insuch an embodiment, the externally threaded portion of the mandrel isconstructed and arranged to engage the internal threading of the throughhole of the one or more fasteners. To deploy the one or more fasteners,a rotator may selectively rotate the one or more fasteners relative tothe mandrel. As the one or more fasteners are rotated relative to themandrel, the threaded portion of mandrel applies a distally directedforce to the internal threading of the fastener heads to move the one ormore fasteners in a distal direction and sequentially deploy the one ormore surgical fasteners into an underlying prosthetic and/or tissue.

For the purposes of this application, a transverse dimension of the coilbody or head generally refers to a dimension of the coil body or headwithin a plane that is perpendicular to a long axis of the surgicalfastener when it is assembled (e.g. a diameter of a cylindrical coilbody, a width of a rectangular head, the length of a side of atriangular coil body, etc . . . ). For example, an outer transversedimension of the coil body would refer to the lateral distance betweenopposing outer surfaces of the coil body and an inner transversedimension of the coil body would refer to the lateral distance betweenopposing interior surfaces of the coil body. The outer transversedimensions of the head T_(H) and coil body T_(C) in two possibleembodiments are illustrated in FIGS. 4B and 8B and correspond to thewidth of the head and the diameter of the coil body. It should be notedthat in embodiments in which the head and/or the coil body arenoncircular, the head and/or coil body may have both minimum and maximumtransverse dimensions.

In view of the above, depending on the particular application, atransverse dimension of the distally extending coil body may be variedto offer different clinical benefits associated with the surgicalfastener. For example, in one embodiment, the distally extending coilbody has an inner transverse dimension that is approximately the same asa pitch diameter of the threading within the through hole of thefastener head. In such an embodiment, the distally extending coil bodyengages the corresponding external threading on the mandrel. Further insome embodiments the coil body may extend through the through hole ofthe fastener head to form the internal threading of the fastener head.In the above embodiment, the coil body is engaged with, and is thussupported by, the mandrel along its entire length which may help toguide and stabilize the coil body of the surgical fastener duringdeployment. Without wishing to be bound by theory, supporting the coilbody during deployment may aid in preventing unwanted buckling orcompression of the surgical fastener during deployment. Additionally, asurgical fastener including a coil body with a smaller ratio of coiltransverse dimension to fastener head transverse dimension may provideincreased mechanical advantage during deployment when a rotator appliesa torque to the head of such a surgical fastener.

In another embodiment, a minimum inner transverse dimension of thedistally extending coil body is larger than a maximum transversedimension of the through hole and a maximum outer transverse dimensionof the threaded portion of the mandrel. Providing a surgical fastenerwith a larger minimum coil body transverse dimension allows the surgicalfastener to engage larger tissue areas, but the surgical fastener mayexhibit decreased mechanical advantage during deployment as compared tothe above embodiment because the coil transverse dimension to headtransverse dimension ratio is larger. Further, because the distallyextending coil bodies have a minimum inner transverse dimension largerthan the maximum outer transverse dimension of the threaded portion ofthe mandrel, they will not be engaged with the mandrel to support thesurgical fasteners thereon. Instead, the surgical fasteners aresupported on the threaded portion of the mandrel solely by the internalthreading located in the through holes of the individual fastener heads.Since the distally extending coil body of the surgical fastener is notsupported on the corresponding mandrel, the individual coil bodies maybe subject to compression and/or buckling during deployment. Therefore,in some embodiments, it may be desirable to provide one or more guidefeatures associated with the surgical fasteners to avoid buckling and/orcompression of the distally extending coil bodiess and ensure properinsertion into tissue during deployment.

It should be understood that the coil bodies and heads of the surgicalfasteners may be made from any appropriate materials or combination ofmaterials including various appropriate metals and polymers.Additionally, the material may be selected such that the surgicalfastener is non-absorbable or bioabsorable as the current disclosure isnot so limited. For example, the distally extending coil body and thehead may be made from: stainless steels such as 316L stainless steel;nickel titanium based alloys such as nitinol; polypropylene; highdensity polyurethane; ultrahigh molecular weight polyethylene (UHMWPE);nylon; polyester; magnesium; zinc; polylactic acid; polyglycolic acid;or any other appropriate material.

In addition to the surgical fasteners, the various components of thedeployment device, including the mandrel and rotator, may be made fromany appropriate material or combination of materials including variousappropriate metals and polymers. Appropriate materials include, but arenot limited to: stainless steels such as 316L stainless steel; nickeltitanium based alloys such as nitinol; polypropylene; high densitypolyurethane; ultrahigh molecular weight polyethylene (UHMWPE); nylon;polyester; or any other appropriate material.

For the sake of clarity, the currently disclosed embodiments aredirected to a laparoscopic device. However, the current disclosure isnot limited to laparoscopic devices. Instead, the currently disclosedsurgical fasteners and associated deployment devices may be used withany appropriate device capable of deploying a fastener into tissue. Forexample, any of the currently disclosed components, or combination ofdisclosed components, could be incorporated into an endoscopic device, aborescopic device, a catheter, a surgical instrument for use in “open”procedures, or any other appropriate surgical instrument. Additionally,the deployment device may be loaded with one or more fasteners prior tobeing provided to an end user, or it may be constructed to allow theuser to load one or more fasteners.

Turning now to the figures, specific embodiments of the surgicalfasteners and the associated deployment devices are described in moredetail. However, it should be understood, that embodiments differentfrom those depicted in the figures are contemplated.

FIG. 1 depicts a deployment device in the form of a laparoscopicsurgical instrument 2 for deploying one or more surgical fasteners. Thedeployment device 2 includes a handle 4 at a proximal end of the device.The handle includes a trigger 6. The deployment device also includes anouter elongated shaft 16 extending in a distal direction from the handle4. When the trigger 6 is actuated, a surgical fastener is deployed froma distal tip of the elongated shaft 16. It should be understood, thatthe deployed surgical fastener may be deployed into any appropriateprosthetic, bone, and/or tissue . For example, in one embodiment, asurgical fastener can be deployed into a soft tissue repair fabric, suchas a surgical mesh, as well as an underlying tissue for repairing ahernia.

FIG. 2 depicts an exploded view of the deployment device 2 of FIG. 1. Asdepicted in the figure, the deployment device includes a mandrel 10, arotator 14, and an outer elongated shaft 16. The mandrel 10 includes athreaded portion 12 for supporting one or more surgical fasteners, notdepicted. When assembled, the mandrel 10 is disposed within the rotator14 which is disposed in the outer elongated shaft 16. The trigger 6 iscoupled to the rotator 14 via a transmission 8 such that actuation ofthe trigger 6 rotates the rotator 14 relative to the mandrel 10. Asdescribed in more detail below, this rotation of the rotator 14 relativeto the mandrel 10 rotates the surgical fasteners disposed on thethreaded portion 12 of the mandrel, not depicted. Rotation of thesurgical fasteners relative to the threaded portion 12 of the mandreldisplaces the surgical fasteners in a distal direction and deploys adistal most fastener into a prosthetic and/or tissue. It should beunderstood, that the rotator 14 and transmission 8 may be embodied inany number of different ways in order to rotate the fasteners relativeto the mandrel 10. Therefore, it should be understood, that the currentdisclosure is not limited to only the rotator 14 and transmission 8depicted in the figures and described below.

In one embodiment, the elongated shaft 16 is articulable. In such anembodiment, it is desirable that the mandrel 10 and the rotator 14 bedesigned to accommodate articulation of the elongated shaft 16 whilestill being capable of deploying a surgical fastener. This may beprovided in any number of ways. For example, in one embodiment,rotatable links and/or slots may be provided along a portion of themandrel and/or rotator length in the articulable portion of the device.Alternatively, the mandrel and/or rotator may be made from a flexiblematerial, or include a flexible material within the articulated portionto permit rotation of the rotator when articulated. In yet anotherembodiment, the rotator and mandrel may be made from rigid materialslocated in a rigid distal portion of the elongated shaft thatarticulates about a joint. A transmission may then be used to transmitpower from the trigger and through the articulating joint to deploy asurgical fastener. Other embodiments to permit articulation of thedeployment device are also possible. Further embodiments in which thedeployment device is not articulable are also possible.

In some embodiments, the mandrel 10 is held rotationally and axiallystationary relative to the handle 4 and/or the outer elongated shaft 16.However, the mandrel 10 might also be held rotationally stationaryrelative to the handle 4 and/or outer elongated shaft 16 and may bemovable in a proximal and distal direction. In such an embodiment, themandrel 10 may advance in a distal direction during deployment of asurgical fastener to extend the mandrel outside of the distal end of theouter elongated shaft 16. The mandrel 10 may then retract in a proximaldirection after a surgical fastener has been deployed. The mandrel mayinclude either a pointed distal tip 26 to aid in positioning thefastener relative to soft and/or hard tissues, or the distal tip 26 maybe blunt as the current disclosure is not limited in this fashion.

In some embodiments, it may be desirable to increase the deploymentand/or retention force of the surgical fasteners relative to the mandrel10. Consequently, the threaded portion 12 of the mandrel andcorresponding threading on the surgical fasteners may include multiplethreads. For example, the threaded portion 12 of the mandrel and theinternal threading of the surgical fasteners, not depicted, may includeat least two threads, three threads, four threads, or any otherdesirable number of threads as the current disclosure is not limited inthis respect. Without wishing to be bound by theory, in addition toproviding increased retention and deployment forces, the multiplethreads may also help to stabilize the surgical fasteners on the mandrelas they are distally displaced through the elongated shaft andsubsequently deployed into an underlying prosthetic and/or tissue.

Having generally described the various components of the deploymentdevice, FIG. 3 depicts a close-up exploded perspective view of thedistal end of one embodiment of the mandrel 10 and the rotator 14. Aplurality of surgical fasteners 18 are disposed on the threaded portion12 of the mandrel. As depicted in the figures, the surgical fasteners 18include a head 20 and a distally extending coil body 22 attached to thehead. In this embodiment, the head 20 and distally extending coil body22 of each surgical fastener 18 are constructed and arranged to engagewith the threaded portion 12 of the mandrel. However, as described inmore detail below, embodiments in which the distally extending coil body22 has a minimum inner transverse dimension larger than the threadedportion 12 of the mandrel, and thus is not engaged with the mandrel,also are contemplated. As indicated by the arrow, the mandrel 10, aswell as the plurality of surgical fasteners 18 disposed thereon, arepositioned within the rotator 14. As described in more detail below, thedepicted rotator 14 is an outer drive cannula with a cross-sectionalprofile that complements a shape and size of the fastener heads 20.Therefore, rotation of the rotator 14 relative to the mandrel rotatesthe fasteners 18 relative to the threaded portion 12 of the stationarymandrel. This rotation of the surgical fasteners 18 relative to thethreaded portion 12 of the mandrel, distally displaces the one or moresurgical fasteners and deploys a distal most surgical fastener into anunderlying prosthetic and/or tissue.

FIGS. 4A-4C depict one embodiment of a surgical fastener 18 for use withthe deployment device described above. In the depicted embodiment, thesurgical fastener 18 includes a distally extending coil body 22 that isattached to a head 20 including a through hole 24 with an internalthread. Further, the inner transverse dimension of the distallyextending coil body 22 is selected such that one or more of theindividual coil windings of the distally extending coil body 22 engageswith the threaded portion of the mandrel along either a portion orsubstantially the entire length of the coil body 22 distally extendingfrom the head 20. In some embodiments, the coil body 22 may pass throughthe through hole 24 to form the internal threading located therein. Thecoil body 22 is attached to the head 20 using any appropriate method.For example, the coil body 22 may be integrally formed with the head 20or it may be manufactured separately and attached using a compressionfit, adhesives, mechanical interlocking features, threading,interference fits, or any other appropriate method.

FIG. 5 depicts an embodiment of a mandrel 10 including a threadedportion 12 a for use with the surgical fastener depicted in FIGS. 4A-4C.The threaded portion 12 a includes a single thread with the same pitchas the coil windings of the coil body 22. Additionally, the threadedportion 12 a is sized to engage both the internal threading of thethrough hole 24 and the distally extending coil windings of the coilbody 22 as well. While a blunted distal tip 26 is depicted, a pointedtip might also be used.

As best shown in FIG. 4A, the head 20 of the surgical fastener has ashape including a series of flats and rounded portions. In order toengage the heads 20 of the surgical fasteners, the rotator 14,corresponding to the distally extended elongated outer drive cannuladepicted in FIGS. 6A-6C, includes an internal cross-sectional shape thatcomplements the shape and size of the heads 20 of the surgicalfasteners. The specific shape of the heads 20 and the internalcross-section of the rotator 14 is selected such that rotation of therotator 14 rotates the fasteners 18 relative to the mandrel 10 withminimal or no slip. While a specific shape is depicted in the figures,other shapes are also possible. For example, the fastener heads andcorresponding cross-sectional shape of the rotator may also correspondto a triangle, a quadrilateral, a pentagon, an asymmetrical shape, orany other appropriate shape capable of transferring rotation of therotator 14 to the fasteners 18. It should be understood that embodimentsin which the rotator only complements a portion of the shape and size ofthe heads also are contemplated.

FIGS. 7A-7C depict various cross-sectional views of the assembledmandrel 10, rotator 14, and a plurality of surgical fasteners 18 to helpillustrate how the deployment device functions. As illustrated in thefigures, the mandrel is disposed inside of the rotator 14 with theplurality of surgical fasteners 18 disposed thereon. In the depictedembodiment, the heads 20 of the surgical fasteners are engaged with theinternal cross-section of the rotator 14 and the coil windings of thecoil body 22 are engaged with the thread portion 12 a of the mandrelalong their entire lengths. During actuation, the rotator 14 is rotatedrelative to the mandrel 10. As the rotator 14 is rotated, the internalcross-section of the rotator applies a torque to the head 20 of eachfastener 18. This torque rotates the fasteners 18 relative to themandrel 10. Due to the internal threading of the coil bodies and/orheads engaging the threaded portion 12 a of the mandrel, rotating theheads will apply a distally directed force to the internal threading ofthe surgical fasteners 18 and displace the surgical fasteners 18 in adistal direction. As the surgical fasteners 18 are displaced in a distaldirection, a distal most fastener is displaced out of the distal end ofthe deployment device and into an underlying prosthetic and/or tissue.

In some instances, it may be beneficial to provide either a compressiveor tensile force to a prosthetic and/or tissue that the surgicalfastener is deployed into. Therefore, in some embodiments, the pitch ofthe coil windings of the coil body may be different from a pitch of theinternal threading of the through hole and the associated threadedportion of the mandrel it is engaged with. For example, the coilwindings might have a pitch in a relaxed position that is less than apitch of the internal threading of the through hole and the associatedthreaded portion of the mandrel. In such an embodiment, the coil bodymay be deformed to an elongated state while it is positioned on thethreaded portion of the mandrel. After the coil body is deployed intotissue, the coil body may contract towards its relaxed position andprovide a compressive force to the prosthetic and/or tissue it isdeployed into. Similar to the above, in order to provide a tensile forceto the prosthetic and/or tissue, the coil windings may have a pitch thatis greater than a pitch of the threaded corresponding portion of themandrel.

FIGS. 8A-8D and 9 depict another embodiment of a surgical fastener andan associated deployment device. Similar to the above, the surgicalfastener 18 includes a distally extending coil body 22 attached to ahead 20 including a threaded through hole 24. However, in thisembodiment, an inner transverse dimension of the coil body 22 is greaterthan a transverse dimension of the through hole 24 and an associatedthreaded portion 12 b of the mandrel depicted in FIG. 9. While the coilbody 22 may be attached to the head 20 in any appropriate fashion, inthe depicted embodiment, a proximal end of the coil body 22 creates ancompression fit with a shoulder 28 of the head.

In this embodiment, since the coil body 22 is larger than the throughhole 24 and the associated threaded portion 12 b of the mandrel, thecoil does not engage the threaded portion 12 b of the associatedmandrel. Therefore, the surgical fastener 18 will be solely supported onthe threaded portion of the mandrel by the internal threading located inthe through hole 24. In such an embodiment, the internal threading ofthe through hole 24 may include multiple threads to increase thestability of the surgical fastener on the mandrel as well as the forceapplied during deployment. In the depicted embodiment, the surgicalfastener 18 includes two internal threads within through hole 24.

To further increase stability and the force applied to the surgicalfasteners 18 during deployment, it may also be desirable to provide atleast a minimum amount of engagement between the internal threading ofthe through hole 24 and the associated threaded portion 12 b of themandrel. For example, a fastener head including a single thread mightinclude at least a full turn of the thread. Similarly, a fastener headincluding two threads might include at least a half turn of each threadto provide at least a combined full turn of engagement with the multiplethreads. It should be understood that other numbers of threads andeither greater or lesser amounts of combined thread engagement are alsopossible.

FIG. 9 presents an embodiment of a mandrel 10 including a threadedportion 12 b configured to engage with the internal threading of thethrough hole 24 of the surgical fastener depicted in FIGS. 8A-8D. Sincethe surgical fastener depicted in the figures has two internal threads,the threaded portion 12 b of the mandrel also has two correspondingexternal threads as well. Additionally, the mandrel 10 also includes apointed distal tip 26. As noted above, the pointed distal tip can beinserted into a prosthetic and/or tissue to aid in positioning thefastener. In such an embodiment, the mandrel 10 may either be displacedto extend out of a distal end of an associated deployment device, or itmay fixed such that it extends out of the distal end of an associateddeployment device. While a pointed distal tip has been depicted with thecurrent embodiment, a blunt tip might also be used.

FIGS. 10A-10C depict the surgical fasteners 18 of FIGS. 8A-8D includinga coil body that has a larger minimum inner transverse dimension than amaximum outer transverse dimension of the associated through hole and/orthreaded portion of the mandrel. To aid in visualization, an associatedrotator is not depicted. Similar to the other embodiment describedabove, the internal threading of the through hole 24 of each surgicalfastener 18 is engaged with the threaded portion 12 b of the mandrel.However, as noted above, the distally extending coils 22 are not engagedwith the threaded portion 12 b of the mandrel because it has a largerinner transverse dimension. So, as the surgical fasteners 18 are rotatedrelative to the mandrel 10, the threaded portion 12 b of the mandrelwill apply a distally directed force to the internal threading locatedin the through hole 24 of each surgical fastener, but will not interactwith the distally extending coil bodies directly. Therefore, similar tothe other embodiment, this results in the surgical fasteners undergoingboth rotation and displacement in a distal direction to deploy thesurgical fasteners from the distal end of a deployment device and into adesired prosthetic and/or tissue.

While a particular rotator with a particular cross-sectional shape hasbeen depicted in the figures and described above, it should beunderstood that any appropriate rotator capable of rotating the surgicalfasteners relative to the mandrel may be used. Appropriate rotators mayalso include: different cross-sectional shapes; distally extending armsthat engage corresponding features on the surgical fasteners; a rotatorthat only engages a portion of the cross-section of the surgicalfasteners; keyed features, combinations of the above, and any otherappropriate rotator.

In addition to the above, while the depicted surgical fasteners have afastener head with a particular cross-sectional shape, it should beunderstood that any appropriate fastener head capable of being engagedby the rotator may be used. For example, other types of features and/orshapes, such as slots, holes, grooves, tabs, and/or combinations of theabove, might be used to associate the surgical fasteners with therotator.

In other embodiments, it may be desirable to increase the retentionforce of the surgical fasteners in tissue. One possible way in which todo this is to use a coil body including multiple parallel and distallyextending coil windings attached to the fastener head. Therefore, insome embodiments, the surgical fasteners may include at least two,three, or any desirable number of parallel and distally extending coilwindings attached to the fastener head.

While the present teachings have been described in conjunction withvarious embodiments and examples, it is not intended that the presentteachings be limited to such embodiments or examples. On the contrary,the present teachings encompass various alternatives, modifications, andequivalents, as will be appreciated by those of skill in the art.Accordingly, the foregoing description and drawings are by way ofexample only.

What is claimed is:
 1. A deployment device comprising: a handle; a shaftextending distally from the handle; one or more surgical fastenersdisposed in the shaft, the one or more surgical fasteners including ahead and a distally extending coil body attached to the head, whereinthe head includes a through hole with an internal thread; a mandrelincluding a threaded portion, wherein the threaded portion is engagedwith the internal thread of the head of the one or more surgicalfasteners; and a rotator associated with the one or more surgicalfasteners, wherein the rotator selectively rotates the one or moresurgical fasteners relative to the mandrel to displace the one or moresurgical fasteners in a distal direction.
 2. The deployment device ofclaim 1, wherein both the threaded portion of the mandrel and theinternal thread include at least two threads.
 3. The deployment deviceof claim 1, wherein the coil body forms the internal thread.
 4. Thedeployment device of claim 1, wherein a minimum inner transversedimension of the coil body is larger than a maximum outer transversedimension of the threaded portion of the mandrel.
 5. The deploymentdevice of claim 1, wherein the coil body of the one or more fasteners isengaged with the threaded portion of the mandrel.
 6. The deploymentdevice of claim 1, wherein the mandrel is stationary.
 7. The deploymentdevice of claim 6, wherein the mandrel is rotationally stationary. 8.The deployment device of claim 7, wherein the mandrel reciprocates in aproximal and distal direction.
 9. The deployment device of claim 1,wherein the mandrel includes a sharp distal tip.
 10. The deploymentdevice of claim 1, wherein a pitch of a coil winding of the coil body isdifferent from a pitch of the threaded through hole and/or the threadedportion of the mandrel.
 11. The deployment device of claim 1, whereinthe threaded portion is located at a distal end of the mandrel.
 12. Thedeployment device of claim 1, wherein at least a portion of the coilbody located distally from the head is threaded to and engaged with thethreaded portion of the mandrel.
 13. A surgical fastener comprising: ahead including a through hole with an internal thread; and a distallyextending coil body attached to the head.
 14. The surgical fastenerclaim 13, wherein the coil body forms the internal thread.
 15. Thesurgical fastener of claim 13, wherein a minimum inner transversedimension of the coil body is larger than a maximum outer transversedimension of the through hole.
 16. The surgical fastener of claim 13,wherein a pitch of a coil winding of the coil is different from a pitchof the internal thread.
 17. The surgical fastener of claim 13, whereinthe internal thread includes at least two threads.
 18. A methodcomprising: rotating one or more surgical fasteners relative to amandrel in a surgical fastener deployment instrument, wherein the one ormore fasteners include a head and a distally extending coil bodyattached to the head, wherein the head includes a through hole with aninternal thread, and wherein the mandrel includes a threaded portionconstructed and arranged to engage with the internal thread of the headof the one or more surgical fasteners, and wherein rotating the one ormore surgical fasteners relative to the mandrel displaces the one ormore surgical fasteners in a distal direction down the surgical fastenerdeployment instrument.
 19. The method of claim 18, wherein both thethreaded portion of the mandrel and the internal thread include at leasttwo threads.
 20. The method of claim 18, wherein the coil forms theinternal thread of the one or more surgical fasteners.
 21. The method ofclaim 18, wherein a minimum inner transverse dimension of the coil bodyis larger than a maximum outer transverse dimension of the threadedportion of the mandrel.
 22. The method of claim 18, further comprisingholding the mandrel stationary.
 23. The method of claim 18, furthercomprising holding the mandrel rotationally stationary.
 24. The methodof claim 23, further comprising reciprocating the mandrel in a proximaland distal direction.
 25. The method of claim 18, wherein the mandrelincludes a sharp distal tip.
 26. The method of claim 18, wherein a pitchof a coil winding of the coil body is different from a pitch of thethreaded through hole and/or the threaded portion of the mandrel. 27.The method of claim 18, wherein the threaded portion of the mandrel isalso constructed and arranged to engage with at least a portion of thecoil body located distally from the head of the one or more surgicalfasteners.